International Assistance and Response Policy Branch

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The International Assistance and Response Policy Branch works with national and international partners to develop policies and plans to facilitate mutual assistance and improve coordination during public health and medical emergencies with both domestic and international implications.

Policy Development and Implementation

The team designs solutions to the complex legal, regulatory, logistical, policy, ethical, and funding challenges that threaten to impede the sending and/or receiving of assistance during public health and medical emergencies at the domestic-international interface.

U.S. Domestic Policy Frameworks for Proving and Accepting Assistance during Emergencies

DIHS has developed a series of policies and plans that have been successfully implemented during the responses to H1N1 (2009) Pandemic Influenza, the Haiti Earthquake, the Fukushima Earthquake and nuclear power plant incident, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Ebola and Zika Viruses outbreaks, and a variety of medical emergencies. This work includes:

Co-leading the International Sharing of Medical Countermeasures Policy Group (ISMPG). The ISMPG is a USG interagency group that convenes on an emergency basis to analyze international requests for MCMs and develop recommendations for U.S. action. Since the formation of the ISMPG, DIHS has convened and led the ISMPG to analyze and respond to over 15 requests from more than a dozen of counties.

Co-leading the HHS International Policy Group for Personnel Sharing (HIPPS). The HIPPS is a USG interagency group that analyzes international requests for public health and medical personnel and develops recommendations for U.S. action. The research on the legal, regulatory, and logistical challenges and considerations for deploying personnel that are included in this Framework were critical to informing the deployment of U.S. Public Health Service Commissioned Corps personnel to W. Africa in response to the Ebola Virus Disease Epidemic.

Co-leading the US Sample Sharing Working Group to develop a draft framework. This framework provides a process by which USG Departments/Agencies can jointly identify, obtain, and coordinate distribution of relevant biological material, and share those materials with the public health research community to facilitate the development of vaccines, therapeutics, and diagnostics.

Leading the development of a USG process to receive, adjudicate, and process international requests for public health and medical assistance during influenza pandemics. It has subsequently been used to coordinate the USG responses to WHO Flash Appeals for financial support during respond to H7N9 Influenza, MERS Co-V, and the Ebola Virus Disease epidemic in 2015.

Developing guidelines for HHS to receive foreign medical and public health assistance from international partners in response to emergencies in the United States when national capacities are overwhelmed.

International Policy Development

Global Health Security Initiative

DIHS leads the Global Health Security Initiative (GHSI) Medical Countermeasures (MCM) Task Force which brings member countries together with the World Health Organization (WHO) to identify and address the legal, regulatory and logistical barriers to the international sharing of medical countermeasures during emergencies. Based on lessons learned from the international deployment of 2009 H1N1 vaccine, the MCM Task Force has developed an operational framework for the international emergency deployment of medical countermeasures. The DIHS Director and Deputy Directors serve as the MCM Task Force Chair and Executive Director, respectively.

DIHS, as an active member of the GHSI Sample Sharing Task Force, has led the development of a framework that has been tested during the Zika outbreak. Critical aspects of it, including a standard Material Threat Assessment (MTA), were used to share Zika Virus samples with GHSI countries at the onset of the oubreak.

At the start of the 2015-2016 Zika outbreak, DIHS stood up the US Sample Sharing Working Group and leveraged our existing international partnerships to acquire the first clinical specimens from patients with Zika virus from the Americas. These critical samples enabled the CDC and FDA to validate diagnostic assays and blood safety screening tests, as well as to start the development of panels for ASPR/BARDA to supply diagnostic manufacturers with material to validate their assays.

Response Policy Coordination

During a large-scale international medical or public health emergency response effort, the ASPR convenes the HHS Disaster Leadership Group (DLG) and depending on the nature of the event, DIHS serves as the international policy advisor to the ASPR and the DLG by:

Co-chairing the International Sharing of Medical Countermeasures Policy Group.

Co-chairing the HHS International Policy Group for Personnel Sharing.

Co-chairing the USG Sample Sharing Working Groups.

Leading communications with international partners including with WHO and the GHSI members through the GHSI emergency communications protocol, NAPAPI, BTB, and formal communications channels through the International Health Regulations protocols.

Examples of DIHS’ Role in Past Emergencies

Designated as the Policy Lead by the Assistant Secretary for Preparedness and Response (ASPR) to coordinate the HHS Disaster Leadership Group meetings and related policy development for MERS-CoV.

Designated as the Policy Lead by the to coordinate the HHS Disaster Leadership Group during the response to the 2011 earthquake and nuclear disaster in Japan, and facilitated communications between the United States, WHO, and the International Atomic Energy Agency (IAEA) through the GHSI radiological and nuclear working group.

Designated as the Policy Lead by the ASPR to coordinate HHS Disaster Leadership Group meetings and related policy development for the Zika Virus Outbreak.

Serve as the policy lead, coordinated and tracked ASPR-wide activities during the Ebola Outbreak in West Africa, as well as advised on preparedness issues with a domestic/international interface.

Led policy development and facilitated international communications on patient evacuation to partner countries following the 2010 Haiti earthquake, as well as facilitated HHS coordination with the United Nations Health Cluster System led by the Pan American Health Organization.

Facilitated the development of the Homeland Security Council sub-Interagency Policy committee on Supporting H1N1 International Requests and Engagement (SHIRE) in 2009.

Led the deployment of 820,000 doses of antivirals to Mexico and WHO/Pan American Health Organization (PAHO), and 16.8 million doses of vaccine to WHO during the 2009 H1N1 influenza pandemic (in coordination with the HHS Office of Global Affairs).